I propose to study the attitude, knowledge and experiences of nurses on prioritizing comfort measures in care of the dying patient in an acute hospital setting. I am particularly interested in this field as I worked in a hospice during semester break where palliative care of the dying concentrated on the quality of life of the patient. When the prognosis for the patient was imminent death, care was focused on reducing the severity of the disease symptoms rather than vainly trying to stop or delay development of the disease itself or provide a cure. When the prognosis for a patient is imminent death, hospice care concentrates on the quality of life of the patient, reducing the severity of the disease symptoms rather than vainly trying to treat the disease itself. To assist in delivery of this type of quality end-of-life care to patients in acute hospitals the Alor Setar Hospital developed a Hospice Friendly Hospital programme (HFH). This HFH developed the Quality Standards for End-of-Life Care in Hospitals to set out a shared vision for the type of end-of life care that each hospital should aim to provide. This development is significant as almost 50% of those who die in Kedah die in hospital and care of the dying in Alor Setar hospitals, while regarded as good, is described as ‘care at the end of life’ rather than ‘end-of-life care’ because the care seems to lack an effective palliative care component”
To investigate international perspectives on end-of-life care, the current international literature was reviewed using the key themes of identifying the dying phase, comfort care and symptom control for the dying patient. It was conclude from the literature review that nurses and medical staff often differed in their approach to care of the dying patient and this hindered effective delivery of end-of-life-care. Education on end-of-life care was recommended in the literature as being a solution to the problems in delivering this care even though research had not been done on the status quo in education.
Before planning such specific education programmes, it would seem necessary to conduct research studies to establish the education and training levels of nurses and doctors in end-of-life care and to establish if attitudes and experience also influence the medical and nursing models in the delivery of this care. This research proposal is concerned with the nursing model and it proposes to establish what influences the nurse’s approach in delivering end-of-life care.
A quantitative approach using a descriptive design is proposed for this study. Questionnaires will be used as the data collection method with a simple random sample of 200 staff nurses employed in a Alor Setar hospital being selected as participants in the study.
The research problem leads to the following research question: “What are the attitude, knowledge and experience of nurses on prioritizing comfort measures for dying patients in an acute hospital?”
(i) To establish the attitude of nurses on prioritizing comfort measures for dying patients.
(ii) To establish if nurses’ knowledge of prioritizing comfort measures for dying patients is adequate.
(iii) To establish if nurses’ experience in prioritizing comfort measures for dying patients is significant.
Introduction to Research Methodology
The methodology selected for the proposed study will be detailed here. The planned research design, methods of sample selection, data collection and analysis of results will be explained. Ethical considerations for this particular research study will also be detailed. It is hoped that the chosen methodology will generate useful information through the collection and analysis of data on the attitude, knowledge and experiences of staff nurses on the effect of comfort measures in care of the dying patient in the acute hospital setting....
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